Phoenix Management LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PHOENIX MANAGEMENT LLC

Practice address

10991 Deerridge Dr.
Chubbuck, ID 83202

Phone

(208) 317-3625

NPI assigned

Mar 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Merinda Halladay

Title

Owner/Administrator

Phone

(208) 317-3625

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1154714897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10991 DEERRIDGE DR.",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "83202",
            "telephone_number": "208-317-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10991 DEERRIDGE DR.",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "83202",
            "telephone_number": "208-317-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "HALLADAY",
        "authorized_official_first_name": "MERINDA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "208-317-3625",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Developmentally Disabled Services Day Training Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.